Provider Demographics
NPI:1710363171
Name:HUDSONALPHA CLINICAL SERVICES LAB LLCC
Entity Type:Organization
Organization Name:HUDSONALPHA CLINICAL SERVICES LAB LLCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:CROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-327-9623
Mailing Address - Street 1:601 GENOME WAY
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-2908
Mailing Address - Country:US
Mailing Address - Phone:256-327-9623
Mailing Address - Fax:
Practice Address - Street 1:601 GENOME WAY
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-2908
Practice Address - Country:US
Practice Address - Phone:256-327-9623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory